C ooperative

A ctive

S elf Directed

E xperiential

The University of Saskatchewan, College of Medicine is making an informed educational decision to pursue the goal of creating an excellent Saskatchewan-style UGME CASE Curriculum focusing on the achievement of Competencies through Cooperative Learning, Active Learning, Self-Directed Learning, and Experiential Learning. In deciding against becoming a “full PBL” school we are not just being rugged prairie individualists nor are we simply balking at the costs involved. Despite a vast number of studies there appears to be no convincing evidence that PBL improves the knowledge base or clinical reasoning skills of students (Albanese, 2000; Colliver 2000).


To help our learners to transfer their knowledge, skills, and attitudes (become strong problem-solvers), we are committed to teaching knowledge, skills and attitudes in clinically relevant contexts, using integrative patient scenarios, or cases. As students learn and progress, the tasks they face will grow with them until the cases and practice exercises are real, authentic situations. This will allow our students to build on success, reinforce prior learning, and become prepared to transfer their learning to new and different situations.

The CASE Curriculum is focused on Competencies

The overall goals of the U of S and MCC Objectives set the ultimate destination for our students. Each course and set of courses will define complementary competencies that will lead directly and integrally to the Goals of the U of S and the MCC objectives. Similarly knowledge and skills at supporting levels must contribute to and be inextricably linked through the competencies to them. The concept of competency assumes both proficient and enduring performance of the behaviour requiring several opportunities for practice and identification of key core knowledge, skills, and attitudes.

The CASE Curriculum incorporates Cooperative Learning (CL)

We believe in best-practice CL which has five important and necessary features: positive interdependence, face-to-face promotive interaction, individual accountability, interpersonal and small group skills, and group processing (Johnson, Johnson, Smith, 1998; Nilson, 1998). Considering the large amount of research over a long period of time that has shown that CL is effective at facilitating learning to work in teams and for transfer, we are committed to incorporating CL environments into our curriculum, programs, and individual teaching sessions.

The CASE Curriculum uses Active Learning (AL)

Active Learning (AL) is an approach to teaching that incorporates one or more of the five elements of talking and listening, reading, writing, reflecting and creating into the engagement by learners in relevant and authentic tasks in a supportive environment. Compared to a traditional approach of passive information transmission, AL produces better learning, including concept formation; increased motivation; discovery of misconceptions; and the acquisition of knowledge, critical thinking, attitudes and values, and interpersonal skills. Case discussions are one example of active learning approaches. Therefore, the College of Medicine will incorporate into all course, programs, and individual teaching session opportunities for students to engage in AL. This does not mean that all teaching and learning will be given in small groups. AL can take place within the traditional large or a small group setting for short or long periods of time.

The CASE Curriculum incorporates opportunities for Self-Directed Learning (SDL)

SDL is a continuum ranging from near-complete teacher or institutional control of the learning tasks and environment to greater learner control. Opportunities for SDL are more limited in professional schools "where the standards for knowledge and performance may be imposed by regulatory agencies or professional organizations, (and) there seems to be little room to allow students to select what and how they learn" (Allen, 1997). Furthermore, some methods, while they personalize and adapt the learning, perhaps as in some forms of PBL may not in any significant way "shift the locus of control from teacher to learner…" (Candy, 1991). Nevertheless, opportunities for meaningful SDL must be present to balance the tight delimitations of knowledge and skills in a competency based curriculum. Therefore, teaching in the College of Medicine will encourage and cultivate a moderate, and genuine form of SDL in our learners.

The CASE Curriculum is based on Experiential Learning (EL)

Our curriculum will employ AL strategies and progress through increasingly complex learning tasks. Whereas CL provides a useful and tested pedagogical approach, EL is the process by which they will tackle these progressively more complex tasks, sometimes in groups. Beginning with a particular experience such as a patient encounter or paper case, students first plan a response to the situation and then carry out their plans. The cycle moves on to an observation or data collection stage and finally to reflection and the creation of general rules and principles. This simple cycle (plan, act, observe, reflect) is a process that will help students approach and learn from experiences they encounter. Therefore, the College of Medicine will encourage and build into its programs explicit emphasis on the experiential learning cycle. This is being accomplished to some degree now and will be expanded in the future.

Clinical Case Resources

References

Albanese M. Problem-based learning: why curricula are likely to show little effect on knowledge and clinical skills. Medical Education, 2000; 34;729-738.
Allen A. Self-directed learning in professional education: guided self-assessment as a tool to facilitate self-directed learning of medical students. In HB Long and Associates (eds.), Expanding Horizons in Self-Directed Learning. University of Oklahoma, 1997.
Candy, P.C. Self-Direction for Lifelong Learning: A comprehensive Guide to Theory and Practice (San Francisco, Jossey-Bass, 1991).
Colliver J. Effectiveness of problem-based learning curricula: research and theory. Academic Medicine, 2000, 75(3);259-266.


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